liver

Question 1

hemolytic anemia is a common cause of

Answer 1

excess production of bilirubin

Question 2

unconjugated bilirubin (indirect)

Answer 2

hydrophobic and nonpolar, bound do albumin

Question 3

how is bilirubin conjugated?

Answer 3

by hepatocytes changing it to glucouronic acid

Question 4

conjugated bilirubin is ____

Answer 4

hydrophilic and secreted into bile

Question 5

final metabolism of bilirubin

Answer 5

by bacteria in the gut, converting to urobilinogen then stercobilin, then eliminated in feces.

Question 6

what is first pass effect?

Answer 6

Liver metabolizes some of the drug before it exits through the hepatic vein.

Question 7

Percent of cardiac output liver receives

Answer 7

20-25%

Question 8

TRUE OR FALSE: Portal vein blood is oxygenated

Answer 8

FALSE - it is deoxygenated

Question 9

The most specific marker for liver damage

Answer 9

ALT - because it is more specific to the liver

Question 10

why do liver enzymes return to normal in End stage liver disease

Answer 10

fewer hepatocytes are dying.

Question 11

most common cause of acute liver injury

Answer 11

drug-induced liver injury

Question 12

activated by liver metabolism

Answer 12

prodrug

Question 13

protein synthesis markers

Answer 13

albumin, PT (reflects production of coagulation proteins)

Elevates with liver failure

Question 14

uptake and biotransformation capacity tests

Answer 14

bilirubin, indirect and direct

Question 15

Tests for fibrosis of liver

Answer 15

ultrasound, MRI, CT, elastography, biopsy

Question 16

antidote to tylenol overdose

Answer 16

N-acetylcysteine (replenishes glutathione

Question 17

Required to detoxify acetaminophen metabolite NAPQI

Answer 17

glutathione

Question 18

toxic metabolite in acetaminophen

Answer 18

N-acyetyl-p-benzoquinone-imine (NAPQI)

Question 19

common findings in acute cholestasis

Answer 19

jaundice

hyperbilirubinemia

Question 20

Blockage of bile flow

Answer 20

cholestasis

Question 21

Most common cause of drug-induced cholestasis

Answer 21

antibiotics

Question 22

findings of acute cholestasis

Answer 22

elevated GGT, ALP, 5” nucleotidase
increase in circulating bile salts
pruritis due to increased bile salts
pale stools, dark urine due to failure of bile secretion

Question 23

causes of cholestasis

Answer 23

gallstones, neoplasms, pancreatic inflammation, reactions to drugs, pregnancy

Question 24

hepatitis A route of infection

Answer 24

fecal-oral

Question 25

diagnosis for hepatitis A

Answer 25

IgM, IgG titers to hep A antigens